![Key icon]( "Key icon")
Key Points
- Two proposed bills in California, SB 1454 and AB 2968, target both facility and patient safety measures
SACRAMENTO, CALIF. — The death of Donda West, mother of rapper Kanye West, following cosmetic surgery last fall has fueled the creation of two proposed California bills that are quickly progressing through the legislative process.
On November 9, 2007, 58-year-old Donda West underwent a breast reduction, tummy tuck and liposuction performed by Jan Adams, M.D., at his Wilshire Blvd. surgery center, according to the Los Angeles Times. After the 5.5-hour surgery, Ms. West went home to recuperate, against a doctor's advice. The next day, paramedics rushed her, unconscious, to a Marina del Rey hospital, where she died, the Times says.
A Los Angeles County coroner's report says Ms. West died from "pre-existing coronary artery disease and multiple post-operative factors" including aspiration of emesis, focal pneumonia, constrictive torso bandaging, probable hemodilution and pain-medication use. However, coroners could not pinpoint the precise cause of death or find evidence of any surgical or anesthetic misadventure, say the report and published accounts.
COSMETIC CHECKUPS Nevertheless, the incident has given rise to two statewide proposals aimed at increasing the safety of California outpatient cosmetic surgery centers. ![]()
Mr. Ridley-Thomas
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The first, Senate Bill 1454, would require such facilities to undergo inspections at least every three years by accrediting agencies approved by the Medical Board of California (MBC). In addition, SB 1454 would require each surgery center to submit to its accrediting agency a detailed plan for handling serious surgical complications or side effects. It also would mandate that any advertising by a physician or other healthcare provider specify the type of degree the practitioner holds. The second proposal, Assembly Bill 2968, would require patients to undergo physical examinations before having any cosmetic surgery.
In commenting on SB 1454, the bill's author, California Senator Mark Ridley-Thomas (D-Los Angeles), told
Cosmetic Surgery Times
, "The bottom line is that we have to ensure a higher standard with respect to quality of care provided by surgery centers and clinics performing cosmetic procedures." Although California law already says such centers should be accredited by a state-recognized agency and be prepared for post-surgical emergencies, he says that problems including Donda West's death and other postsurgical complications persist. To the extent that they do, Mr. Ridley-Thomas states, "We in the California Legislature have an obligation to address them, and we will. That's why the bill is moving through the Legislature as effectively as it has."
Introduced on February 21, 2008, SB 1454 now rests with the California State Assembly. If approved there, the bill will return to the Senate by autumn for Senate members to vote on any amendments made by the Assembly, reports Mr. Ridley-Thomas. Regarding the difficulty of SB 1454's passage, he says, "This bill has very little opposition. As of July 9, 2008, when it was analyzed by the Assembly Appropriations Committee, there was no opposition on file."
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Dr. Shumway
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Robert Shumway, M.D., says that while he's aware of no physicians who oppose the rule in principle, California's cosmetic surgeons want to make sure that whatever rules pass don't interfere with the doctor-patient relationship. He is president of the California Academy of Cosmetic Surgery (CACS), which has written letters supporting SB 1454. He is also an American Academy of Cosmetic Surgery fellow and serves on the American Board of Cosmetic Surgery (ABCS)'s Board of Trustees.
Dr. Shumway believes that having facilities approved and regularly inspected by experts including the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations), the Accreditation Association for Ambulatory Health Care (AAAHC), the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) or California's Institute for Medical Quality will ensure that facilities follow these agencies' guidelines in areas such as how many procedures physicians can perform at once.
